Resources Repository
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ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Evidence Synthesis | Maternal/Reproductive Health | Health Outcomes | Microsimulation | Calibration/Validation | Health Systems | Clinical Care | Health/Medicine | Global -
ArticlePublication 2010Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy …
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy and childbirth safety in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy and pregnancy-associated complications in individual women, and considers delivery location, attendant, and facility level. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged…
Evidence Synthesis | Maternal/Reproductive Health | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Global | Asia & Pacific -
ArticlePublication 2021Individual and Social Determinants of COVID-19 Vaccine Uptake
This article examined the individual, communication and social determinants associated with COVID-19 vaccine uptake using …
This article examined the individual, communication and social determinants associated with COVID-19 vaccine uptake using national survey data collected before vaccines were available in the U.S. Of note, individuals under the federal poverty level and racial and ethnic minorities were oversampled. Outcomes included the likelihood of vaccinating self and dependents (e.g., children). Independent variables included perceptions of risk, exposure to different media for COVID-19 news, political party identification, confidence in scientists and social determinants of…
Evidence Synthesis | Policy/Regulation | Health Outcomes | Infectious Diseases | Social Determinants | Clinical Care | Culture/Society | Health/Medicine | Science/Technology | North America -
ArticlePublication 2021Health Opportunity Cost Threshold for CEA in the U.S.
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, …
Using a modeled cohort of 100,000 individuals in the United States with private health insurance, the authors simulated the short-term mortality and morbidity resulting from increased premium related cancelation of insurance coverage. The authors used this model to estimate cost-effectiveness thresholds, in dollars per quality-adjusted life year (QALY) gained based on health opportunity costs. They reported the number of persons who dropped insurance coverage, resulting number of additional deaths and QALYs lost from mortality and…
Evidence Synthesis | Policy/Regulation | Priority Setting/Ethics | Health Outcomes | Microsimulation | Cost-Effectiveness Analysis | Health Systems | Health/Medicine | North America -
ArticlePublication 2018Comparing Cost-per-QALYs Gained to Cost-per-DALYs Averted
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, …
The authors examined 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 using two databases, the Tufts Medical Center CEA Registry (cost-per-QALY gained studies), and the Global Cost-Effectiveness Analysis (GHCEA) Registry (cost-per-DALY averted studies). Study characteristics that were analyzed included intervention type, sponsor, country, primary disease, and number of CEAs versus disease burden estimates for major conditions. The authors report that cost-per-QALY studies were most often about pharmaceuticals or interventions in high-income countries while cost-per-DALY…
Evidence Synthesis | Policy/Regulation | Cost-Effectiveness Analysis | Health/Medicine | Global -
ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Risk Analysis | Policy/Regulation | Dynamic Transmission | Decision Analysis | Infectious Diseases | Health Systems | Government/Law | Health/Medicine | Science/Technology | Global -
ArticlePublication 2016Using Cost-Effectiveness Evidence to Inform Health Service Provision
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer …
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer will fund a particular service. First, how is the appropriate cost-effectiveness threshold - or threshold range - to be determined? (And should there be a single threshold or multiple thresholds?) Second, how can the valuation of health benefits be refined to better capture the value of treatments to patients and to the economy as a whole? Third, how should a…
Evidence Synthesis | Policy/Regulation | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health/Medicine | Global -
ArticlePublication 2015Population Health Model (POHEM): An Overview
This paper provides an overview of the rationale, methodology and applications of the Population Health …
This paper provides an overview of the rationale, methodology and applications of the Population Health Model (POHEM). POHEM is a health microsimulation model, developed at Statistics Canada in the early 1990s. The authors describe that POHEM draws together rich multivariate data from a wide range of sources to simulate the lifecycle of the Canadian population, specifically focusing on aspects of health. The model dynamically simulates individuals’ disease states, risk factors, and health determinants, in order…
Evidence Synthesis | Policy/Regulation | Costing Methods | Mathematical Models | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2014Effect of Health-Facility Admission and Skilled Birth Attendant Coverage on Maternal Survival in India
Research in areas of low skilled attendant coverage found that maternal mortality is paradoxically higher …
Research in areas of low skilled attendant coverage found that maternal mortality is paradoxically higher in women who seek obstetric care. Using unmatched population-based case-control analysis of national datasets, the authors compared the effect of health-facility admission at any time (antenatal, intrapartum, postpartum) on maternal deaths (cases) to women reporting pregnancies (controls). Probability of maternal death decreased with increasing skilled attendant coverage, among both women who were and were not admitted to a health-facility; however,…
Evidence Synthesis | Maternal/Reproductive Health | Health Outcomes | Health Systems | Health/Medicine | Asia & Pacific